Provider Demographics
NPI:1225176217
Name:GRIMM, QUYNH-ANH D (DDS)
Entity Type:Individual
Prefix:DR
First Name:QUYNH-ANH
Middle Name:D
Last Name:GRIMM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ANH
Other - Middle Name:D
Other - Last Name:GRIMM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:7540 LITTLE RIVER TPKE STE A
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-2839
Mailing Address - Country:US
Mailing Address - Phone:703-642-2828
Mailing Address - Fax:703-642-0209
Practice Address - Street 1:7540 LITTLE RIVER TPKE STE A
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-2839
Practice Address - Country:US
Practice Address - Phone:703-642-2828
Practice Address - Fax:703-642-0209
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401410593122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist